Journal of Aging and Health最新文献

ObjectiveWe compared pain prevalence and intensity between caregivers and non-caregivers, as well as between different types of caregivers.MethodUsing two rounds of data from the National Social Life, Health, and Aging Project, we used regression models to analyze differences in pain prevalence and intensity between caregivers and non-caregivers at baseline (2010-2011) and follow-up (2015-2016). The sample consisted of 2332 participants aged 62 and older (352 caregivers and 1980 non-caregivers).ResultsCross-sectionally, caregivers were more likely than non-caregivers to report pain. Longitudinally, caregivers with pain at baseline were more likely to report the presence of pain and greater pain intensity five years later compared to non-caregivers who also reported pain at baseline. More hours of care per week was associated with greater pain intensity at baseline and follow-up among caregivers with pain.DiscussionCaregivers' pain is a public health concern, with efforts to mitigate the effects of caregiving on pain needed.

ObjectivesThere is growing recognition that social participation may help attenuate cognitive decline in older ages. Unfortunately, previous research often relies on participation index measures, which may obfuscate associations among cognition, specific activities, and the frequency of partaking in those activities.MethodsData are from six waves of the Health and Retirement Study (N = 20,696). Regression models test how associations between social participation and cognition vary by social activity and by multiple specifications of activity frequency.ResultsUsing a participation index, any new activity or increase in activity frequency was positively associated with cognition. When segregating activities, only three activities had positive associations: meeting friends, volunteering, and being a part of community organizations. We find limited evidence that activity frequency is an important moderator.DiscussionSocial activities likely have heterogeneous associations with older adult cognition. The frequency threshold linking social participation to cognition may be "any" regular participation in select activities.

ObjectiveThe aim of this study is to conduct a systematic review of published literature to examine factors associated with Length of Stay (LOS) and Readmission Rates for older Hospital in the Home (HITH) patients.MethodIn accordance with PRISMA guidelines, seven databases were searched for peer-reviewed articles relating to HITH, older patients, LOS and readmissions.ResultsTwenty-nine studies met the inclusion criteria. Risk factors associated with increased readmissions and LOS were age, prior hospitalisations, illness severity, geriatric-related complications, and cognitive impairment. Most studies found that patients participating in HITH had a shorter initial acute hospitalisation LOS than patients transferred to a subacute hospital or rehabilitation ward. However, LOS and readmissions, comparing HITH to traditional in-hospital care, were inconsistent.ConclusionsOverall, LOS and readmission rates (comparing home-based care to hospital care) were inconsistent but appear related to patient demographics and disease profile and require further study.

ObjectiveLimited research has explored how the attributions of discrimination in later life are related to cognitive functioning.MethodsWe analyzed responses from 12,279 adults ages 65+ in the 2008 to 2018 waves of the Health and Retirement Study. Multilevel mixed models assessed whether cognitive functioning was associated with (1) everyday discrimination (without reference to attribution) and (2) frequency of 11 attributions of discrimination.ResultsDescriptive analyses highlighted variability in the characteristics associated with specific attributions of discrimination. We found that age was the most reported attribution of discrimination, followed by gender. Discrimination was associated with worse cognitive functioning, and frequent reports of certain attributions of discrimination (e.g., disability, sexual orientation) were associated with cognitive functioning.DiscussionThese results suggested that discrimination was harmful for cognitive health and that the perceived reasons for discrimination may have unique and negative implications for cognitive functioning among older adults.

ObjectivesThe NIA health disparities research framework details a life course approach that considers multilevel environmental, sociocultural, behavioral, and biological factors. Mixed methods are well-suited to study complex problems like structural racism, combining the benefits of generalizability with contextualization.MethodsWe draw on experience as faculty in the Mixed Methods Research Training Program for the Health Sciences to introduce mixed methods research on health equity and disparities in dementia and cognitive impairment.ResultsWe describe common reasons why health science investigators may use mixed methods, provide examples of mixed methods designs, and discuss challenges and practicalities of mixed methods research.DiscussionMany risk factors for dementia are modifiable, so the emphasis of research turns from description to intervention studies that enhance health equity. The information and insights acquired from the use of mixed methods are central in tailoring interventions to populations most affected by Alzheimer's disease and related dementias.

ObjectiveThe objective of this study was to examine the interrelationships between cognitive performance, race/ethnicity, discrimination, health behaviors, and physiological dysregulation.MethodsWe used data from the Multi-Ethnic Study of Atherosclerosis (MESA) (N = 1667). We used path analyses to examine the association between discrimination, physiological dysregulation, health behaviors, and cognitive performance using the Cognitive Ability Screening Instrument (CASI) at Exam 5 (2010-12) and Exam 6 (2016-18). We examined the relationship between discrimination at Exam 1 (2000-02) and physiological dysregulation at Exam 5. We used overall and ethnoracial-stratified path analysis. All models were adjusted for age, sex, site, depression, stress, socioeconomic status, and APOE-e4.ResultsPhysiological dysregulation was associated with worse cognitive performance in the full sample and among the White ethnoracial subgroup. Everyday discrimination was associated with better cognitive performance among Black participants.DiscussionAssociations between discrimination, physiological dysregulation, and cognitive performance vary and should be examined longitudinally.

Objectives: This study examines the associations of ethnicity, caregiver burden, familism, and physical and mental health among Mexican Americans (MAs) and non-Hispanic Whites (NHWs).

Methods: We recruited adults 65+ years with possible cognitive impairment (using the Montreal Cognitive Assessment score<26), and their caregivers living in Nueces County, Texas. We used weighted path analysis to test effects of ethnicity, familism, and caregiver burden on caregiver's mental and physical health.

Results: 516 caregivers and care-receivers participated. MA caregivers were younger, more likely female, and less educated compared to NHWs. Increased caregiver burden was associated with worse mental (B = -0.53; p < .001) and physical health (B = -0.15; p = .002). Familism was associated with lower burden (B = -0.14; p = .001). MA caregivers had stronger familism scores (B = 0.49; p < .001).

Discussion: Increased burden is associated with worse caregiver mental and physical health. MA caregivers had stronger familism resulting in better health. Findings can contribute to early identification, intervention, and coordination of services to help reduce caregiver burden.

Objectives: Changes in socioeconomic status (SES) during life may impact health in old age. We investigated whether social mobility and childhood and adulthood SES are associated with trajectories of health-related quality of life (HrQoL) over a 17-year period.

Methods: We used data from the Helsinki Birth Cohort Study (n = 2003, 46% men, mean age 61.5 years). Social mobility was derived from childhood SES, obtained from healthcare records, and register-based adulthood SES.

Results: Logistic regression models showed that lower adulthood SES was associated with lower physical HrQoL trajectories. Among men low (OR 3.95, p < .001), middle (OR 2.20, p = .006), and declining lifetime SES (OR 2.41, p = .001) were associated with lower physical HrQoL trajectories compared to men with high SES. Socioeconomic status was not associated with mental HrQoL trajectories.

Discussion: Declining SES during life course may have negative health consequences, while improving SES is potentially as beneficial as high SES to later-life health among men.

Objective: To characterize aging-related health in women with past CLSI and compare with women with no-CLSI.

Method: Health and Retirement Study Wave 11 and 12 data from women age >50 with CLSI were compared with data from women age >50 with no-CLSI. Generalized linear models were estimated for aging-related health outcomes.

Results: The group with CLSI (n = 230) was significantly younger than the no-CLSI group (n = 8035) yet had more physical, functional, and mental health challenges and fewer resources. Incarceration significantly predicted aging-related outcomes of multimorbidity, polypharmacy, mortality, frailty, and depression.

Discussion: Earlier onset of physical and functional health conditions in women with past CLSI has implications for health education and promotion, clinical practice, and intervention design.

ObjectivesEngagement in learning new skills can potentially foster cognitive and functional growth among low-income Latinos, a population at high risk for developing Alzheimer's disease and related dementias. However, they may face unique barriers to learning. The present qualitative study identified learning barriers, learning engagement, and learning interests among low-income Latino older adults.MethodsTwenty Spanish-speaking participants were interviewed utilizing a semi-structured interview protocol. The data were analyzed using a thematic analysis approach.ResultsSome of the identified barriers include lacking good health, finances, learning opportunities, technology, proficiency in English, transportation, and motivation. Participants were most interested in learning technology, English, sewing skills, and culinary arts to primarily improve their financial situation.DiscussionThese findings highlight the privilege of prioritizing leisure activities for novel skill learning in old age for those with more financial resources. Our findings promote the need to provide tailored novel skill learning opportunities for underserved populations.